| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.82 | $3,801.89 | $7,943.28 | |
Aetna
| Professional | $10.00 | $26.92 | $34.67 | |
Medcost
| Facility | $27.54 | $27.54 | $51.29 | |
United
| Facility | $28.18 | $28.18 | $28.18 | |
Wellcare
| Facility | $177.83 | $177.83 | $177.83 |